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Contact Information

TREMONT ROAD DENTAL SUPER, P.C.
2000 DANIEL STUART SQ
WOODBRIDGE, VA22191-3315
 Phone: 770-916-9000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dentist

122300000X
 

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for TREMONT ROAD DENTAL SUPER, P.C.

NPI Number 1255524120
LBN Legal business name TREMONT ROAD DENTAL SUPER, P.C.
Authorized official MICHELLE JACOMINO - (DIRECTOR OF PAYOR RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 08/23/2007
Last updated 01/18/2024 - About 2 years ago
Identifiers
VA License # 0401411091
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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